Paul
Rowen: We have great concerns about this clause, which
grants the Secretary of State sweeping powers that will be reinforced
by regulation, but does not prescribe the limits of some of those
powers. Schedule 3 mentions some of the powers that are granted. In
particular, paragraph 5(1) deals with where information may be obtained
from. It grants Jobcentre Plus staff with the power to obtain
information held by
“a police
force...the probation service, or...any other such person as
may be
prescribed.” We
do not have in this country a statute of limitations stating what
responsibilities and rights people have, but we are granting the
Secretary of State sweeping powers to obtain information about
someone’s health and wellbeing. Returning to the point that I
made this morning, that seems to run counter to the NHS constitution
under which the treatment that someone receives is
fundamentally for them to decide and may be offered by the
NHS. Paragraph 2
of schedule 3 refers to “a substance-relate assessment”
and specifies in great detail how that might proceed. Our view is that
there is a much better way of doing that and that such detailed
regulation is better dealt with in a health Bill rather than a benefits
Bill. The two may be related, but I would be more confident if civil
servants in the Department of Health specified who might be a suitable
person than if a regulation drafted by the Department for Work and
Pensions did so.
Insufficient
thought seems to have been given to how the provision will work. The
Minister said that there will be pilots and that the matter will be
prioritised, but what discussion has taken place with colleagues in the
Department of Health to decide how it will be implemented? In our view,
the worst outcome would be that people who are already on the waiting
list for treatment and are not receiving benefits or who are receiving
benefits but are not in a targeted group will be moved down the list to
accommodate someone whom the Bill determines should receive priority.
That is iniquitous, and not the right way of going about the matter.
During the evidence sessions, reference was made to voluntary schemes
and a proper assessment of them. Why have we not had a proper
assessment of what is already working and how it can be
extended? The
hon. Member for Forest of Dean mentioned Wales. Services throughout
England vary from region to region, and different health authorities
have different levels of provision. What guarantee is there and what
discussions has the Minister had with the Department of Health to
ensure that if a policy is imposed on, for example, the north-west or
the south-west, the resources will be available to implement it and
that it will work?
We are
concerned about this aspect of the Bill, and how it will work in
practice, including civil liberties and the amount of information that
can be obtained from various sources, but which may not be necessary to
enable JCP staff to undertake the job with which they have been
charged. It seems to us that that would be better dealt with elsewhere
than in the
Bill. Mr.
John Baron (Billericay) (Con): I would like to raise a few
concerns about the clause. On the face of it, the proposal is
attractive, because it is not a welcome thought that our taxes and
welfare system are subsidising a life of addiction and perhaps even
crime. However, serious questions must be asked, and I share the
concerns of my hon. Friend the Member for Forest of Dean about whether
the capacity is in place to support the proposals, and whether such an
approach in itself will be ultimately successful.
On capacity,
we heard from our evidence sessions that more than 200,000 drug addicts
are currently in treatment, and the capacity just about keeps pace with
that demand. These figures are easy to bandy around, so I shall ask the
Minister to clarify them if not now then later. We also heard, however,
that about 100,000 addicts currently draw benefits but are not in
treatment. It is difficult to believe that the existing services will
cope with such a big increase in demand without a big increase in
resources. When the chief executive of
DrugScope was questioned, he clearly made the point that it would be
“extremely difficult” for the system to cope with any
extra demand without an increase in resources. What estimate has the
Minister or his Department made of how many extra drug addicts will
require treatment as a result of the proposals? What will be the cost
of that extra provision? And, where will the resources come from? I do
not see any additional resources tagged on to the Bill. I am sure that
the Minister is fully aware that it is all right putting such proposals
in place, but that, if we do not create the capacity to deal with the
envisaged increase in demand, the proposals will be almost
worthless. On the
question of whether the general approach will be successful, all the
evidence suggests that addicts will make progress with treatment only
once they have resolved in their own mind to do so. Some addicts
persist with their habit, despite it costing them their job, health,
home or even their partner and their children, and despite the pain
that that subsequently causes. The question that we as a Committee must
ask ourselves is, are those people seriously going to take advice from,
or respond to, a nice
lady—[Interruption]—or gentleman sitting
behind a jobcentre desk asking them to go for treatment? I have met
many nice people in jobcentre offices, and they can be very tenacious,
determined and gritty while being compassionate. However, they have
only certain powers of persuasion, and when addicts have caused so much
pain to themselves and, perhaps, others, and gone to such lengths to
pursue their habit, one must question whether the policy will succeed.
Indeed, the chief executive of DrugScope has said:
“There
is no evidence that using benefit sanctions to compel problem drug
users into treatment will be effective. Withdrawing benefits could
perversely drive some people further away from the support they need,
potentially impacting upon their families and wider
communities”.
I suggest to
the Minister that if people are forced into treatment that proves
wholly ineffective, it at best wastes valuable time and resources and,
at worst, delays the moment when they finally get serious about giving
up or about re-entering work. Perhaps worse than that, such an approach
risks diverting scarce and valuable resources from those who are more
serious about giving up their habit. What evidence does the Minister
have to suggest otherwise—that using benefit sanctions to force
addicts into treatment will be effective? And, what measures will he
put in place to ensure that resources are not diverted from where they
are most needed and from people who genuinely want to give up their
habit? I look forward to hearing his responses to those
questions.
5.45
pm
John
Mason: I have a lot of sympathy with a number of concerns
that have been mentioned already. I will make a few points.
Do we have
clear definitions of some of the terminology used in the Bill? One such
term is “propensity to misuse”. How many people clearly
have that propensity? How many do not? How many would be in a grey
area? Even the word “dependent” needs to be defined. Most
of us would probably feel that we could tell whether somebody was
dependent on drugs or alcohol, but my understanding is that when
scientific tests are taken on somebody, all they can tell is whether a
drug is present in that person’s body, not whether they are a
regular user. There may be other ways of doing that.
Can
the Minister assure us that he will be working with the Scottish
Government, within our national drugs strategy? That has changed in
recent years from managing, as has already been mentioned, and just
giving people methadone with or without support, and now includes
tackling the drug problem that many people have. In Glasgow, and in
other parts of Scotland, there is a real drug problem. None of us is
running away from that or pretending that that is not the
case.
There is an
idea that, if savings are made through benefit reductions, those funds
can go through back into the Scottish budget to give more support to
drug users. This point has already been made but it is worth
emphasising: many people on drugs are in need of help more than
anything else. Many of them probably greatly regret that they are on
drugs, but they need the motivation to come off. If they do not have
that motivation, I am not convinced that a lot of sanctions are really
going to help. Even if they do want to come off, DrugScope told us that
we are talking seven or eight years for somebody to come off heroin,
which is a serious length of time.
Finally, what
happens to the children in families headed by drug addicts? I asked
that question to Barnardo’s in the earlier Committee meeting and
its chief executive seemed somewhat stumped by it. But we are also
committed to tackling child poverty. How do we tie these in? If the
family income reduces, does that mean that the children suffer? And
where, in practical terms, does the family end up? Do they go on to
steal? Are they dependent on their grandparents, who, on limited means,
help in supporting the kids? Or does it just mean that the kids eat
less?
The
Parliamentary Under-Secretary of State for Scotland (Ann
McKechin): It is a pleasure to serve under you this
afternoon, Mr. Hood.
I welcome
this debate. It is clearly on a very serious issue which affects many
of our constituencies, particularly for the three members of the
Committee who represent Glasgow seats, where we are all well aware of
the damage that it causes. The debate is on the basis that we want to
set up a new contract, between applicants on one side and the
Government on the other, about where the responsibilities lie. The aim
is to provide a more tailored package which adequately deals with the
needs of people who suffer from drug misuse. Such people are moved much
further away from the job market as a result of their drug misuse,
which permanently affects their lifestyle. Against that background, we
have decided that it is important that we first of all focus on those
who have the most chaotic lifestyles. That is why we will initially
target those using heroin and crack cocaine, because that is the group
which causes the most harm to themselves, their families and
society.
Every year
the use of class A drugs costs society £18 billion in
health and crime costs alone. Ninety-nine per cent. of that is caused
by problem drug use. So it is appropriate that we target this group
first, because it is the group with the most propensity to harm. But as
a number of Members said this afternoon, it is also important that we
carry out this pilot first and then roll out the service in a way that
allows our health services to have the appropriate capacity to
cope.
There have
been record levels of investment in treatment for drug misuse in
England, which has led to a large expansion in capacity and dramatic
reductions in waiting
times. Ninety-three per cent. of drug users are
receiving treatment within three weeks of being assessed. The
Department of Health and the Department for Work and Pensions have
looked closely at likely numbers being referred into treatment from
jobcentres, and we do not believe that capacity will be an issue,
although we will monitor this very closely. We will have local drug
jobcentre co-ordinators funded by the Department of Health and in post
by spring this year. We will be keeping an eye on any potential pinch
points and drawing those to the attention of the local drugs
partnership. The
National Treatment Agency for Substance Misuse will be monitoring data
on waiting times and the provisions of the Bill will be piloted, so
that should problems with implementation occur pilots can be
terminated, or the system delayed in rolling out countrywide, until
these issues are resolved.
The hon.
Member for Forest of Dean mentioned the issue of queue jumping. I can
assure him that there is no question of benefit claimants queue jumping
into treatment. If, on occasion, more people need a particular type of
treatment than there are current places, it would be the job of the
local drugs partnership to make decisions on the basis of clinical
need, not the route to referral. We are quite clear about
that.
Mr.
Baron: I was interested to hear the hon. Lady’s
comments about pinch points. Given the numbers involved and the
estimates that came out of the evidence sessions, there could be up to
100,000 extra addicts looking for treatment. What happens if these
pinch points do occur? What action will the Government take to resolve
the situation? What measures will be in place to ensure that pinch
points do not result in long
delays?
Ann
McKechin: It is important that we work on a local basis,
where we can consider the local capacity of drug services in the area.
That is why we want the staff of the DWP and the Department of Health
to work very closely together—if the pinch point is in
England—to ensure that, if there is a pinch point, the
appropriate steps are taken within jobcentres to make referrals out
into the health service. We want to ensure that we do not end up in the
position where there would be any significant increase in waiting times
for treatment for any person who has come through the jobcentre route
or any other clinician route. That is why it is important that there is
a degree of local control and management rather than an entirely
centralised system. That is why we will be appointing co-ordinators to
deal with
that.
Mr.
Baron: If the hon. Lady cannot answer this question now,
then she could perhaps come back later, but it is no good saying that
pinch points will be monitored locally and their effect can be
minimised. If we are talking about getting anywhere near the figures
suggested in the evidence sessions, we are not talking about pinch
points; we are talking about, perhaps, an overloading of the system, at
least in certain areas. What specific measures will the Government take
to ensure that they can cope with that? I am talking about possible
additional resources being required here, because we heard in the
evidence sessions that existing capacity is only just keeping up with
demand, before this extra demand—we think—comes into
play. What extra resources will the Government commit to this to ensure
that this does not become a major issue?
Ann
McKechin: The position in England is a very healthy one:
the average wait for referrals is three weeks. For those of us in
Scotland, we are waiting for up to 52 weeks; we would love
to be anywhere close to what there is in England. There has certainly
been no lack of commitment by this Government in putting resources into
drug treatment here in England.
The hon.
Gentleman raises an important question, however; it is the very reason
why we are going to pilot this over a two-year period, and why we will
report back to Parliament on any successes or problems that may occur.
It is also why we have included a sunset clause in these
provisions—so that Parliament will have another opportunity to
consider the terms of the pilot and whether it has been a success. This
gives a degree of reassurance that, as a Government, we will have to
meet the demand, but we also have to make sure that we roll out the
demand in a way that is manageable—not only on a national scale
but also in terms of local health services. We are very keen to ensure
that that is the case.
Mr.
Harper: The Minister said that the pilots in England would
run over a two-year period. When the Minister for Employment and
Welfare Reform was pressed on this in the evidence session, he said it
would take that length of time to get the provision of treatment
services in Wales and Scotland to a point at which a pilot in those two
parts of the United Kingdom was a meaningful
prospect.
Mr.
McNulty indicated
dissent.
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